Granos de polen anemófilos: sensibilización en pacientes alérgicos / Anemophilic pollen grains: sensitization in allergic patients

A nivel mundial, los aeroalérgenos más frecuentes causantes de enfermedades alérgicas son los granos de polen anemófilos. Estos han sido capaces de desencadenar crisis que han reflejado una elevada morbilidad. En Cuba los estudios de sensibilización a granos de polen han sido escasos. Con el objetivo de determinar la sensibilización a granos de polen en pacientes alérgicos y su relación con la presencia de enfermedades alérgicas, se realizó un estudio observacional descriptivo de corte transversal, no aleatorizado, de marzo a junio del 2019. La muestra se constituyó de 33 pacientes con asma, rinitis, rinoconjuntivitis alérgica, dermatitis atópica y conjuntivitis alérgica. A todos los pacientes se les realizó historia clínica alergológica y prueba cutánea por punción con extractos alergénicos de: Helianthus annus, Cosmos bipinnatus, Cynodon dactylon, Quercus sp, Eucaliptus sp. Se aplicaron las frecuencias absolutas, porcientos, desviación estándar, promedio, edad media y test de Spearman para su análisis. La edad media de la muestra fue de 36,9 años, con predominio de mujeres. Más del 50por ciento de los pacientes presentaron sensibilización a granos de polen; y de ellos, el 24,24por ciento resultaron polisensibilizados. El mayor porcentaje de sensibilización fue a Cynodon dactylon. La rinitis alérgica fue la enfermedad que prevaleció en la población estudiada(AU)

Nowadays, the most frequent aeroallergens causing allergy diseases have been anemophilous pollen grains. They have been able to triggers crises that have reflected a high morbidity. In Cuba, studies of sensitization to pollen grains have been scarce. The objective of our research was to determine the sensitization to pollen grains in allergic patients and its relationship with the presence of allergic diseases. A non-randomized, descriptive, cross-sectional, observational study was conducted from March to June 2019. The sample consisted of 33 patients with asthma, allergic rhinitis, rhinoconjunctivitis, atopic dermatitis and allergic conjunctivitis. All patients underwent allergic history and skin prick test testing with allergenic extracts of: Helianthus annus, Cosmos bipinnatus, Cynodon dactylon, Quercus sp, Eucalyptus sp. Absolute frequencies, percentages, standard deviation, mean, average age, and Spearman´s test were applied for analysis. The average age of the sample was 36.9 years, with a predominance of women. More than 50percent of the patients presented sensitization to pollen grains; of them, 24.24percent polysensitized. The highest percentage of sensitization was to Cynodon dactylon. Allergic rhinitis was the disease that prevailed in the population studied(AU)

Seguridad de las vacunas SOBERANAS® en niños, hijos de trabajadores de una institución de BioCubaFarma / Safety of SOBERANAS® vaccines in children of workers of a BioCubaFarma institution

En un complejo contexto epidemiológico nacional e internacional, de trasmisión y hospitalización por COVID-19 en población pediátrica, Cuba decidió realizar una campaña de vacunación masiva contra esta enfermedad en niños y adolescentes. El objetivo de este trabajo fue evaluar la seguridad del esquema heterólogo de dos dosis de SOBERANA®02 más una dosis de SOBERANA®Plus con 28 días entre ellas en niños y adolescentes, hijos de los trabajadores del Centro Nacional de Biopreparados, que pertenece a BioCubaFarma, Grupo Empresarial de las Industrias Biotecnológica y Farmacéutica de Cuba. La seguridad de las vacunas se evaluó mediante la identificación y clasificación de los eventos adversos por farmacovigilancia activa y pasiva. Se evaluaron 237 niños de ambos sexos, siendo incluidos 200 (130 con edades de 2 a 10 años y 70, de 11 a 18). Ciento noventa niños de los incluidos (95 por ciento) recibieron el esquema completo de vacunación. Se registraron un total de 121 eventos adversos, en su mayoría por farmacovigilancia pasiva, de intensidad leve y de causalidad A1 (relacionados). No ocurrieron eventos adversos graves relacionados. Las vacunas SOBERANA®02 y SOBERANA®PLUS evidenciaron un perfil de seguridad muy favorable durante su administración a niños y adolescentes, hijos de los trabajadores del Centro Nacional de Biopreparados(AU)

In a complex national and international epidemiological context of transmission and hospitalization by COVID-19 in the pediatric population, Cuba decided to carry out a massive vaccination campaign against this disease in children and adolescents. The aim of this work was to evaluate the safety of the heterologous scheme of two doses of SOBERANA®02 and one dose of SOBERANA®PLUS with 28 days between them, in children and adolescents who are sons of workers of the Centro Nacional de Biopreparados which belongs to BioCubaFarma, the Business Group of the Biotechnological and Pharmaceutical Industries of Cuba. The safety of the vaccines was evaluated through the identification and classification of adverse events by active and passive pharmacovigilance. A quantity of 237 children of both sexes was evaluated, and 200 were included (130 from 2 to 10 years, and 70 from 11 to 18 years). Of those included, 190 children (95percent) received the complete vaccination schedule. A total of 121 adverse events were recorded, mostly due to passive pharmacovigilance, of mild intensity and A1 (related) causality. No related serious adverse events occurred. The SOBERANA®02 and SOBERANA®PLUS vaccines showed a very favorable safety profile during their administration to children and adolescents who are sons of workers at the Centro Nacional de Biopreparados(AU)

Tratamiento de la rinitis alérgica en época de pandemia. Documento de consenso de sociedades médicas de América Latina y el Caribe / Treatment of allergic rhinitis in pandemic times. Consensus statement from medical societies of Latin America and the Caribbean

La rinitis alérgica ha ido en aumento en los países latinoamericanos, dando lugar a una creciente población de pacientes que necesitan tratamiento médico para esta afección respiratoria. Su similitud con la COVID-19 en cuanto a síntomas y la posibilidad de concurrencia con esta, hacen que la rinitis alérgica sea de particular interés para los sistemas de salud. Los países de América Latina y el Caribe han sido particularmente vulnerables por múltiples desafíos, entre estos, las altas tasas de pobreza, el acceso limitado a la atención médica y las limitaciones en la prestación de servicios básicos de salud, así como la ausencia de guías de tratamiento para la rinitis alérgica en situación de pandemia. Con el objetivo de proporcionar orientación esencial para los equipos multidisciplinarios de América Latina y el Caribe con respecto a la evaluación y el tratamiento de la rinitis alérgica durante la pandemia de COVID-19, se revisó literatura científica publicada sobre tratamiento de la rinitis alérgica y COVID-19, y se consideró la opinión de profesionales líderes de sociedades científicas de la región. Se analizaron las diferentes medidas para evitar contagios, y las diferentes estrategias de tratamiento con énfasis en la terapia intranasal y el tratamiento con vacunas contra la alergia. Se formuló una declaración de posicionamiento con la intención de mantener la continuidad del servicio médico en el contexto de una pandemia y minimizar la propagación, infección y complicación asociada con el coronavirus tipo 2 del síndrome respiratorio agudo severo en pacientes con seguimiento o comenzando tratamiento para la rinitis alérgica(AU)

Allergic rhinitis has been increasing in Latin American countries, leading to a growing population of patients who need medical treatment for this respiratory condition. Its similarity to COVID-19 in terms of symptoms and the possibility of concurrence with it, make allergic rhinitis of particular interest to health systems. The countries of Latin America and the Caribbean have been particularly vulnerable due to multiple challenges, including high poverty rates, limited access to medical care and limitations in the provision of basic health services, as well as the absence of guidelines of treatment for allergic rhinitis in a pandemic situation. With the aim of to provide essential management for multidisciplinary teams in Latin America and the Caribbean regarding the evaluation and treatment of allergic rhinitis during the COVID-19 pandemic, published scientific literature on the treatment of allergic rhinitis and COVID-19 was reviewed, and the opinion of leading professionals from scientific societies in the region was considered. The different measures to avoid infections and the different treatment strategies were analyzed, with an emphasis on intranasal therapy and treatment with allergy vaccines. A position statement was formulated with the intention of maintaining continuity of medical service in the context of a pandemic and minimizing the spread, infection and complication associated with severe acute respiratory syndrome coronavirus 2 in patients undergoing or starting treatment for allergic rhinitis(AU)

Caracterización de la rinitis alérgica en el Hospital Universitario General Calixto García. Octubre 2016-Octubre 2017 / Characterization of allergic rhinitis in the General Calixto Garcia University Hospital. October 2016-October 2017

Las enfermedades alérgicas van en aumento importante en todo el mundo. La rinitis alérgica es una enfermedad inflamatoria crónica de la mucosa nasal IgE mediada, alérgeno-específica con participación de diversas células. Nos propusimos caracterizar la rinitis alérgica en pacientes atendidos en el Hospital Universitario General Calixto García. Se realizó un estudio observacional descriptivo de corte transversal, no aleatorizado, entre octubre 2016 y octubre 2017. En una muestra de 100 pacientes que cumplieron los criterios de inclusión, se realizó historia clínica alergológica empleando variables como: edad, sexo, antecedentes patológicos personales y familiares, procedencia, manifestaciones clínicas, y prueba cutánea por punción. Predominó el sexo femenino entre 30 y 39 años de edad, de área urbana, antecedentes patológicos familiares y personales de asma y conjuntivitis. La rinitis intermitente leve prevaleció en nuestro estudio, así como la sensibilidad a Dermatophagoides pteronyssinus. La tercera década de la vida fue la edad promedio de los pacientes. Se concluye que los pacientes presentaron una alta sensibilidad a Dermatophagoides pteronyssinus. La rinitis persistente leve, con la mitad de los casos, obtuvo mayor predominio por la duración de los síntomas(AU)

Allergic diseases are increasing significantly worldwide. Allergic rhinitis is a chronic inflammatory disease of the nasal mucosa, IgE-mediated, allergen-specific with the participation of various cells. The aims of this study was to characterize allergic rhinitis in patients treated at the General Calixto García University Hospital. Descriptive cross-sectional non-randomized observational study was carried out between October 2016 and October 2017. A sample of 100 patients who meet the inclusion criteria was studied. Allergological medical history was performed using variables such as age, sex, personal and family pathological history, origin, clinical manifestations, and puncture skin test. Female sex predominated between 30 and 39 years old, urban area, family and personal pathological history of asthma and conjunctivitis. Mild intermittent rhinitis predominated in our study. Sensitivity to Dermatophagoides pteronyssinus. The third decade of life was the average age of the patients in this study. We summarize that patients had presented a high sensitivity to Dermatophagoides pteronyssinus. Mild persistent rhinitis with half of the cases had a greater predominance for the duration of symptoms(AU)

Subcutaneous allergen immunotherapy for asthma: A randomized, double-blind, placebo-controlled study with a standardized Blomia tropicalis vaccine.

BACKGROUND: Sensitization to Blomia tropicalis (Bt) is very frequent in the tropics, and particularly in Cuba, being a significant cause of allergic asthma. Allergen immunotherapy (AIT) with Bt can be a therapeutic option, however, placebo-controlled clinical trials have not been reported. OBJECTIVE: To assess the therapeutic effect and safety of AIT for asthma using a standardized allergen vaccine of B. tropicalis by subcutaneous route, in allergic asthmatic patients exposed and sensitized to this mite species. METHODS: A double-blind, placebo-controlled Phase II trial was conducted in 35 adults (18 with treatment and 17 with placebo), with mild to moderate asthma, predominantly sensitized to Bt. AIT was administered subcutaneously in increasing doses from 4 to 6000 Biological Units using a locally manufactured standardized extract (BIOCEN, Cuba). Patient assessment was performed using symptom-medication score (SMS), peak expiratory flow and skin reactivity relative to Histamine as measured by skin prick test (SPT). RESULTS: The 12-month treatment achieved a significant (p < 0.001) decrease of SMS. Symptom score showed only 41% (CI: 26-61) of placebo values, whereas medication was 34.5% (22.4%-63.3%). Treatment was regarded clinically effective in 67% of patients (OR 32; 95%CI: 17 to 102). The effect size on symptoms and medication was higher than has been reported with equivalent allergen dosages of D. pteronyssinus and D. siboney in Cuban asthmatic patients. Skin reactivity to Bt was also significantly reduced (p = 0.0001), increasing 148-fold the allergen threshold to elicit a positive skin test. This desensitization effect was specific to Bt and did not modify the reactivity to Dermatophagoides. The change of specific skin reactivity was significantly (p < 0.05) correlated to clinical improvement. All adverse events were local with a frequency of 2.4% of injections. CONCLUSIONS: Subcutaneous AIT with Blomia tropicalis was effective and safe in asthmatic adults exposed and sensitized to this mite species in a tropical environment. TRIAL REGISTRATION: Cuban Public Registry of Clinical Trials: RPCEC00000026 (WHO International Clinical Trial Registry Platform ICTRP).

Systematic review about 10 interventions in dermatitis. A document from the Latin American Society of Allergy, Asthma, and Immunology.

The Latin American Society of Allergy, Asthma, and Immunology (SLAAI) conducted a systematic search in the Medline and LILACS' database in order to get articles linked to 10 current questions about dermatitis. The assessment of the quality of the evidence and the strength of the recommendations was made through the GRADE system. The completeness and transparency of the recommendations for this clinical guide were assessed with the AGREE Reports Verification Checklist. The final document was shared with physicians, allergists, dermatologists, and pediatricians, and with patients and academic institutions such as universities and medical scientific societies for external assessment. According to the review, clinical scales should be used to measure the severity of the dermatitis, and some interventions such as the use of probiotics may benefit the patient; nevertheless, more studies are required before this management option can be used in the everyday practice. Other interventions such as dietary restrictions and the use of antihistamines seem to be well-founded only in particular cases and they should not be a general recommendation for all patients. This practical guide presents recommendations for the treatment of atopic dermatitis; these recommendations can be helpful for medical staff, patients, and health systems.

La Sociedad Latinoamericana de Asma, Alergia e Inmunología realizó una búsqueda sistemática en la base de datos de Medline y LILACS para obtener artículos relacionados con 10 preguntas actuales sobre dermatitis. La evaluación de la calidad de la evidencia y la fuerza de las recomendaciones se realizaron a través del sistema GRADE. La integridad y la transparencia de las recomendaciones se evaluaron con la lista de verificación de informes AGREE. El documento final se compartió con médicos, alergólogos, dermatólogos y pediatras, pacientes e instituciones académicas, como universidades y sociedades médicas científicas, para su evaluación externa. Conforme a la revisión, se debe usar escalas clínicas para evaluar la gravedad de la dermatitis; algunas intervenciones como el uso de probióticos pueden beneficiar al paciente, sin embargo, se requieren más estudios antes de utilizarlas en la práctica diaria. La restricción de la dieta y el uso de antihistamínicos parecen tener fundamento solo en casos particulares y no deben indicarse a todos los pacientes. Esta guía práctica presenta recomendaciones para el tratamiento de la dermatitis atópica que pueden ser útiles para el personal médico, los pacientes y los sistemas de salud.

[Prevalence, incidence and factors associated with adverse reactions to foods in Cuban infants. A population-based cohort study]. / Prevalencia, incidencia y factores asociados con reacción adversa a alimentos en infantes cubanos. Estudio de cohorte de base poblacional.

BACKGROUND: The prevalence of asthma and allergic diseases in Cuban children is high, but little is known about adverse reactions to foods. OBJECTIVE: To determine the prevalence, incidence and risk factors for adverse reaction to foods in children. METHODS: Population-based cohort study carried out in Havana, Cuba, in a three-year period. Parents of 1543 children provided medical and lifestyle information from the first to the third year of age, which was collected using a questionnaire. An adverse reaction to foods was defined by medical diagnosis reported by the parents or caregivers. RESULTS: Annual cumulative incidence was 5.7%, 1.9% and 0.8%, whereas annual prevalence was 5.7%, 4% and 2.5% at 1, 2 and 3 years of age, respectively; 8% of infants had experienced an adverse reaction to foods when they turned 3 years of age. Cow milk was the most commonly implicated food. Main risk factors were allergenic food consumption, use of antibiotics, factors related to the presence of allergens, maternal history of overweight during pregnancy and allergy to insect bites. CONCLUSIONS: Adverse reaction to food is a significant clinical problem in children from Havana. Modifiable risk factors were identified, the understanding of which will help to direct effective intervention strategies.

Antecedentes: Aunque la prevalencia del asma y enfermedades alérgicas en niños cubanos es alta, se conoce poco de las reacciones adversas a alimentos. Objetivo: Determinar prevalencia, incidencia y factores de riesgo para reacciones adversas a alimentos en niños. Métodos: Estudio de cohorte de base poblacional de La Habana, Cuba, en un periodo de tres años. Los padres de 1543 niños proveyeron datos médicos y de estilos de vida del primer al tercer año de edad, colectados con un cuestionario. La reacción adversa a alimentos fue definida por diagnóstico médico reportado por los padres o cuidadores. Resultados: La incidencia acumulada anual fue 5.7, 1.9 y 0.8 % y la prevalencia anual de 5.7, 4 y 2.5 % al uno, dos y tres años, respectivamente; 8 % de los infantes a los tres años tuvo una reacción adversa a alimentos. La leche de vaca fue el alimento más implicado. Los principales factores de riesgo fueron consumo de alimentos alergénicos, uso de antibióticos, factores relacionados con la presencia de alérgenos, historia materna de sobrepeso durante el embarazo y alergia a picaduras de insectos. Conclusiones: La reacción adversa al alimento es un problema significativo en los niños de La Habana. Se identificaron factores de riesgo modificables, cuya comprensión puede dirigir las intervenciones.

Is peanut causing food allergy in Cuba? Preliminary assessment of allergic sensitization and IgE specificity profile to peanut allergens in Cuban allergic patients.

BACKGROUND: Peanut allergy is increasing at an alarming pace in developed countries. Peanut (Arachis hypogaea) is a common food in Cuba. Nevertheless, reported values of sensitization and symptom severity are usually low. As our objective, we carried out an evaluation of allergic sensitivity to perform an assessment of allergic sensitization and IgE specificity profile to peanut allergens in Cuban allergic patients. METHODS: The Skin Prick Test (SPT) was performed for each patient, using two glycerinated allergenic extracts, prepared from raw or roasted peanuts. Overall, 316 food allergic patients (159 adults and 157 children) attending allergy services at four hospitals in Havana were included, as well as 303 adult non- allergic volunteers. The IgE binding profile of 26 selected SPT positive patients was further analyzed by immunoblotting. RESULTS: The prevalence of sensitization to peanut was 4.6% in general adult population, whereas in adult food-allergic patients it was 18.6%. Prevalence rates were even greater in food allergic children achieving 25.8%. Sensitization frequencies were apparently greater for roasted, as compared to raw peanuts, although the difference was not significant (p> 0.05, Mc Nemar's). IgE binding was shown mostly by the 15 and 17 kDa bands, tentatively identified as the major allergens Ara h 2 and Ara h 6. The IgG4 binding profile was similar to IgE, although with more prominence of the bands at 37 and 28 KDa, corresponding to an Ara h 3 fragment and Peanut Agglutinin. DISCUSSION: The study estimated a relatively high prevalence of peanut sensitization in population. Data reported here suggest that IgE sensitization in Cuban patients is focused mostly on MW bands corresponding to the major allergens Ara h 6 and Ara h 2. CONCLUSIONS: Sensitization to peanut allergen is indeed relatively frequent in Cuba. The IgE profile is congruent to a sensitization pattern by ingestion of roasted peanuts and is directed to well-known major allergens.

[Sensitivity and specificity of prick skin test with two concentrations of standardized extract of Culex quinquefasciatus in allergic children]. / Sensibilidad y especificidad de la prueba cutánea por punción con dos concentraciones del extracto estandarizado de Culex quinquefasciatus en niños alérgicos.

BACKGROUND: Diagnostic options for immune reactions to mosquito bites are limited. In Cuba, IgE-mediated reactions are frequently related to Culex quinquefasciatus bite. OBJECTIVE: To determine the sensitivity and specificity of skin prick test with two doses of standardized extract in nitrogen protein units (PNU of Culex quinquefasciatus (BIOCEN, Cuba). MATERIAL AND METHOD: An analytical study was conducted on 100 children between 2 and 15 years old. Fifty atopic patients with a history of allergy to mosquito bite and positive specific serum IgE Culex quinquefasciatus and fifty atopic patients without a history of allergy to mosquito bite and negative specific serum IgE to Culex quinquefasciatus. Skin prick tests (SPT) were performed by duplicates on the forearms of the patients. Investigated doses were 100 PNU/mL and 10 PNU/mL. RESULTS: SPT with the highest concentration obtained a mean wheal size of 22.09 mm2 and for lower doses of 8.09 mm2, a statistically significant difference (p=0.001, Student's t test). Positive skin test correlated in 100% of patients with the presence of specific IgE. Testing with both doses showed a 94% of specificity and 88% of sensitivity. CONCLUSION: The diagnostic accuracy of SPT using both doses of standardized extract was similar, which justifies its use for diagnosis of sensitization to Culex quinquefasciatus in patients with symptoms of allergy to mosquito bite.

Antecedentes: las opciones diagnósticas de las reacciones inmunológicas a la picadura del mosquito son limitadas. En Cuba, las reacciones mediadas por IgE más frecuentes son por picadura de Culex quinquefasciatus. Objetivo: determinar la sensibilidad y especificidad de la prueba cutánea por punción con dos dosis del extracto estandarizado en unidades de nitrógeno proteico (UNP) de Culex quinquefasciatus (BIOCEN, Cuba). Material y método: estudio analítico efectuado en 100 niños entre 2 y 15 años de edad: 50 pacientes atópicos con antecedentes de alergia a la picadura de mosquito e IgE sérica específica positiva a Culex quinquefasciatus y 50 pacientes atópicos sin antecedentes de alergia a la picadura de mosquito e IgE sérica específica negativa a Culex quinquefasciatus. La prueba cutánea por punción se realizó por duplicado en los antebrazos de los pacientes. Las dosis investigadas fueron 100 y 10 UNP/mL. Resultados: en la prueba cutánea por punción con el extracto de mayor concentración se obtuvo un tamaño del área del habón de 22.09 mm2 y con la menor concentración de 8.19 mm2; una diferencia estadísticamente significativa (p=0.001, prueba t de Student). La prueba cutánea positiva se correlacionó en el 100% de los pacientes con la existencia de IgE específica. La prueba con ambas dosis mostró 94% de especificidad y 88% de sensibilidad. Conclusión: la alta coincidencia en el resultado de la prueba cutánea nos muestra que puede sustituirse la concentración del extracto a 100 UNP/mL por la de menor concentración, sin perder confiabilidad en el diagnóstico de sensibilización al mosquito Culex quinquefasciatus, utilizando ese método in vivo.

Desensibilización con aspirina en un paciente con intolerancia a antiinflamatorios no esteroides / Aspirin desensitization in a patient who exhibit intolerance to non-steroidal anti-inflammatories

El ácido acetilsalicílico o aspirina es uno de los medicamentos más utilizados a nivel mundial. Los pacientes con enfermedad coronaria requieren tratamientos prolongados con este medicamento, el cual se les niega a aquellos con historias de reacciones adversas a este. Se recoge en la literatura internacional el uso de terapias de desensibilización en pacientes con intolerancia a los antiinflamatorios no esteroides con diferentes protocolos, con resultados satisfactorios. En este trabajo se describe la primera desensibilización con aspirina realizada a un paciente en el Hospital Universitario Calixto García y el protocolo de actuación utilizado. No se encontró otro caso en la bibliografía nacional. El paciente actualmente ingiere 125 mg diarios sin reacciones adversas. Se considera que la desensibilización con aspirina es una opción terapéutica efectiva en aquellos pacientes con intolerancia a esta y con una afección que justifique este proceder

Aspirine is one of the most widely used drugs worldwide. The patients suffering from heart diseases require long-term treatment with this drug, which is banned to those having adverse reactions. The international literature collects information on the use of desensitization therapies in patients who do not exhibit tolerance to this medicine, following different protocols with satisfactory results. This paper described the first aspirin desensitization procedure, which was performed at Calixto García university hospital, and the performance protocol. There was not any other case of this type reported in the national literature. The patient can presently take 125 mg of aspirin daily without suffering adverse events. It was considered that the desensitization process is an effective therapeutic action for patients who are aspirin sensitive and who have specific diseases that warrant this procedure

[Assessment of nutritional status in children with atopic dermatitis]. / Evaluación del estado nutricional en niños con dermatitis atópica.

INTRODUCTION: There has been described some exacerbating factors for atopic dermatitis, including foods. Several investigations have reported controversial results about the influence of foods on atopic dermatitis. But there is scarce information about the nutritional status of patients with atopic dermatitis. OBJECTIVE: To characterize the nutritional condition in a sample of children with atopic dermatitis in Old Havana, Cuba. METHODS: In this descriptive study, were included 60 children, aged between 2 and 14 years, with the diagnosis of atopic dermatitis from the Allergy Department in the municipality Havana, from January to April of 2008. For every patient we evaluated anthropometrics, biochemical and immunologic measurements, as well the frequency of meals ingestion and the types of foods. RESULTS: We found that 83.3% of the patients were younger than 6 years, with a slight prevalence of females (53.3%). Ninety-seven percent of the children had a normal height for its age and 48.3% had a normal weight for their height, and 20% of the patients had malnutrition. It was detected mild and moderate anemia in 63.3%. The daily frequency of taking breakfast was carried out in 55%, the lunch in 100% and dinner in 95%. The products of regular consumption are carbohydrates, candies nd sodas in 76.6%. Fish and shellfish are consumed only for 16% of the patients. CONCLUSIONS: In the studied sample of children with atopic dermatitis we found a high prevalence of malnutrition associated with poor dietary habits. Breast milk feeding was related to a less malnutrition percentage in children with atopic dermatitis.

Sensibilización a dermatophagoides pteronyssinus, dermatophagoides siboney y blomia tropicalis en niños de tres consultorios / Sensitization to dermatophagoides pteronyssinus, dermatophagoides siboney and blomia tropicalis in children from three family physician’s offices

La morbilidad de las enfermedades alérgicas mediadas por el anticuerpo IgE, se ha incrementado en los últimos 40 años y además, se han identificado a los ácaros domésticos como sus principales agentes causales. En Cuba, los ácaros más frecuentemente son: Dermatophagoides pteronyssinus (D. pteronyssinus), Dermatophagoides siboney (D. siboney) y Blomia tropicalis (B. tropicalis). En este estudio investigamos si la sensibilización a estos ácaros constituye un problema de salud en nuestra población infantil y su relación con la exposición al polvo doméstico. Se seleccionaron 103 niños alérgicos del pueblo de Guatao, que se clasificaron según su grado de exposición al polvo doméstico. A todos se les realizó la prueba por punción cutánea por duplicado en ambos antebrazos y se utilizaron los extractos alergénicos estandarizados VALERGEN-BT Ò (Blomia tropicalis), VALERGEN-DS Ò (Dermatophagoides siboney) y VALERGEN-DP Ò (Dermatophagoides pteronyssinus), todos de producción nacional en el Centro Nacional de Biopreparados. La sensibilización fue mayor de forma significativa (p<0,01) para todos los ácaros en los pacientes con mayor exposición al polvo doméstico con respecto a los de menor exposición. Además, registramos una sensibilización mayor a los ácaros del género Dermatophagoides, especialmente para el D. pteronyssinus. El extracto D. pteronyssinus provocó un tamaño medio del habón mayor que los otros productos en los pacientes positivos de ambos grupos (p<0,04), por lo que concluimos que la mayor exposición de los pacientes al polvo doméstico está relacionada con una mayor sensibilización a los ácaros

Prevalencia de la sensibilización a tres ácaros domésticos en la población infantil alérgica de un consultorio médico / Prevalence of sensitization to three house dust mites in the allergic infantile population of a family physician's office

Se realizó un estudio con el objetivo de investigar si la sensibilización a estos ácaros ( Dermatophagoides pteronyssinus [ Dp ], Dermatophagoides siboney [ Ds ] y Blomia tropicalis [ Bt ] ) constituye un problema de salud en nuestra población infantil, pues el estudio de los problemas alérgicos ha identificado a los ácaros domésticos como los principales agentes causales de asma y otras afecciones. Se seleccionaron 32 niños alérgicos de nuestro consultorio que se clasificaron según su grado de exposición al polvo doméstico. A todos se les realizó la prueba por punción cutánea en el brazo derecho, y se utilizaron 3 extractos alergénicos estandarizados Valergen Ò ( Blomia tropicalis, Dermatophagoides siboney y Dermatophagoides pteronyssinus ) de producción nacional (BIOCEN). La prevalencia de la sensibilización fue mayor de forma significativa (p<0,05) para todos los ácaros en los pacientes con mayor exposición al polvo doméstico con respecto a los de menor exposición. Para los ácaros del género Dermatophagoides se obtuvo una sensibilización mayor. El extracto de Dp provocó un tamaño medio del habón mayor que los otros productos.

A study was conducted aimed at investigating if the sensitization to these dust mites (Dermatophagoides pteronyssinus [Dp], Dermatophagoides siboney [Ds] and Blomia tropicalis [Bt] ) is a health problem in our infantile population, since the study of the allergic problems has identified the house dust mites as the main agents causing asthma and other affections. 32 allergic children of our office were selected and classified according to their degree of exposure to house dust. All of them underwent the skin test in the right arm. 3 standardized allergenic extracts ValergenÒ (Blomia tropicalis, Dermatophagoides siboney y Dermatophagoides pteronyssinus) of national production (BIOCEN) were used. The prevalence of sensitization was significantly higher (p<0.05) for all the dust mites in patients with a greater exposure to house dust compared with those with lower exposure to it. A higher sensitization was attained for the dust mites of the genus Dermatophagoides. The extract of Dp produced a wheal with a mean size greater than the one caused by other products.

[Comparison of two lancets in the skin prick test]. / Comparación de dos lancetas en la prueba cutanea por punción.

BACKGROUND: The skin prick test is used to diagnose the allergic sensitization. Its results depend upon several factors, such as the lancet type. In Cuba, the most frequently used are: ALK lancet and blood lancet. OBJECTIVE: To compare these two lancets regarding the size of the wheal, precision, sensitivity and specificity of the skin prick test and, finally, the preference of the patients to one of them. PATIENTS AND METHODS: The study was performed in 60 allergic patients, aged 15-50 years, seen at the allergy service of Hospital Universitario Clínico Quirúrgico General Calixto García. The skin prick test was performed on the forearm of all patients included, using both lancet types. A negative control (diluent solution) was applied, together with a 54.3 mmol/L histamine solution in five replicates. RESULTS: The mean size of skin reaction to histamine was 6 mm, using a 1 mm single peak lancet (ALK), size was 6.5 mm when using blood lancet (significant difference p < 0.05). Precision, sensitivity and specificity of ALK lancet were 9.7, 100 and 100%, respectively. On the other hand, the respective values for blood lancet were 15.9, 96 and 87%. Of those studied, 27% presented mild pain and 3% moderate pain using the ALK lancet; while 25% showed mild pain and 10% moderate pain using the blood lancet. CONCLUSION: The ALK lancet showed more precision, sensitivity and specificity and it was preferred by the patients.